Postpartum depression in adolescent mothers before and during COVID-19 and the role of self-esteem, maternal self-efficacy, and social support

Introduction. Although the COVID-19 pandemic negatively impacted the mental health of vulnerable populations, such as adolescent mothers, very few studies have documented the prevalence of postpartum depression (PPD) in this population. Objective. a) Determine the frequency of PPD (Edinburgh Postnatal Depression Scale [EPDS] [greater than or equal to] 9) in adolescent mothers before (AM-BP) and during (AM-DP) the pandemic, b) Examine psychosocial factors (self-esteem, maternal efficacy, social support, depression and anxiety in pregnancy planned and wanted pregnancy) in AM-BP and AM-DP, and c) Determine whether being an AM-DP was a significant factor for experiencing PPD (EPDS [greater than or equal to] 9). Method. Cross sectional study. Subjects: Forty-one AM-BP recruited at Health Centers and interviewed face to face and forty-one AM-DP surveyed online. Results. PPD (EPDS [greater than or equal to] 9) was 42% (p = .001) more frequent in AM-DP. The groups differed significantly in all psychosocial factors, with AM-DP faring worse. Unadjusted regressions showed that being an AM-DP, having lower maternal efficacy and self-esteem, greater dissatisfaction with social support, and depression and/or anxiety in pregnancy increased PPD (EPDS [greater than or equal to] 9). Adjusted multiple analysis indicated that lower self-esteem was the only factor to maintain its association with PPD (EPDS [greater than or equal to] 9; p = .017). Discussion and conclusion. The pandemic negatively affected PPD (EPDS [greater than or equal to] 9) and psychosocial factors in AM-DP, as compared to AM-BP, with self-esteem being the main factor associated with PPD (EPDS [greater than or equal to] 9). In situations of extreme stress as happened in the pandemic, the mental health of adolescent mothers should be prioritized to prevent negative effects such as PPD. PPD preventive and treatment interventions should consider strengthening self-esteem. Keywords: Adolescents, postpartum depression, maternal self-efficacy, self-esteem, social support, COVID-19. Introducción. La pandemia por COVID-19 tuvo un impacto negativo en la salud mental de poblaciones vulnerables, como las madres adolescentes, no obstante, escasos estudios documentaron la prevalencia de depresión posparto (DPP) en esta población. Objetivo, a) Conocer la frecuencia de DPP (Escala Edinburgh para la Depresión Postnatal [EPDS] [mayor que o igual a] 9) en madres adolescentes antes de la pandemia (MA-AP) y durante la pandemi